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A Multicenter Randomized Double-blind Placebo-controlled Pilot Study of Safety, Pharmacodynamics and Efficacy of Different Treatments of Immunotherapeutic Drug Mobilan (M-VM3) in Patients With Diagnosed Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Unknown status
Phase
Phase 1
Locations
Russian Federation
Study Type
Interventional
Intervention
Mobilan (M-VM3)
Placebo
Sponsored by
Panacela Labs LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring prostate cancer, adenovirus, TLR5, immunotherapy, Ad5

Eligibility Criteria

45 Years - 75 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subscribed Informed consent for participation in the trial
  2. Men aged 45 to 75 years
  3. Patients with histologically verified prostate cancer, stage Т1-Т3, N0, M0
  4. Patient's ECOG status 0-2
  5. Negative tests for serologic markers of HIV-infection, viral hepatitis В and С, syphilis
  6. Patient and his partner should agree to use barrier contraception throughout the study period

Exclusion Criteria:

  1. Failure to obtain Informed consent
  2. Clinical or radiological signs of metastases
  3. Indication to hormone therapy of prostate cancer
  4. Clinically significant cardiovascular diseases:

    • Myocardial infarction within 6 months prior the screening
    • Unstable stenocardia within 3 months prior the screening
    • Severe circulation failure (FC III)
    • Clinically significant arrhythmias
    • Hypotension (systolic blood pressure < 86 mm Hg) or bradycardia with HR < 50 beats per min.
    • Uncontrolled arterial hypertension (systolic blood pressure > 170 mm Hg or diastolic blood pressure > 105 mm Hg.)
  5. Clinically significant CNS diseases at the screening
  6. Current infection or another severe or systemic disease which increases risk of treatment sequel
  7. Pituitary gland or adrenal disorders in medical history
  8. Other malignant tumors within the last 5 years
  9. Other concomitant diseases in medical history which according to Investigator may aggravate during the study, including uncontrolled diabetes mellitus, rectal diseases, rectal fissures, hemorrhoid, rectal polyps, rectostenosis, inflammatory urinary diseases: chronic prostatitis, cystitis, urethral catheter, chronic urine retention.
  10. Complicated allergic history, systemic allergic reaction, any dietary allergy, intolerability, limitations or specific diets which according to the Investigator may be a contraindication for subject participation in the present study.
  11. Administration of drug products which have a marked effect on immune system within 3 previous months prior the screening, long-term intake of disaggregants (warfarin, low molecular heparin except for ThromboASS).
  12. Participation in other clinical studies or administration of investigational drug products within 30 days prior the screening, or persisting adverse reactions of any investigational drug product.
  13. Any clinically significant patient's health disorders and/or laboratory abnormalities not enlisted in the Protocol which are identified at the screening, and/or any reason which according to the Investigator may prevent the patient's participation in the study.
  14. Drug or alcohol abuse at the screening or in the past which according to the Investigator makes the patient ineligible for participation in the study.
  15. Vaccination made 14 days prior the study
  16. Unability to understand or follow study instructions
  17. Lack of availability during 6 months after administration of the investigational drug product, fails to follow visit schedule

19. Individual intolerability of the investigational drug product components

Study withdrawal criteria:

  1. Any patient may refuse from the study participation on his own wish in any moment on any study stage.
  2. Principal Investigator may withdraw any patient from the study in the following cases:

    • Investigator makes the decision that a patient should be withdrawn in his own best interests
    • Patient develops any serious adverse reactions/events in the screening period
    • Patient has been enrolled to the study with violations, or does not follow the protocol requirements
    • Patient needs additional treatment in the screening period
  3. Sponsor has right to terminate the study in any moment.
  4. Regulatory authorities have right to terminate the study in any moment.

Sites / Locations

  • Moscow State Budgetary Healthcare Institution "City Clinical Hospital № 57" of Moscow Healthcare Department
  • Moscow State University of Medicine and Dentistry
  • Federal State Budgetary Institution "Saint Petersburg Clinical Scientific and Practical Center for Special types of medical care (Oncological)"
  • Federal State Budgetary Institution "Scientific Research Oncology Institute named after N.N. Petrov" of the Ministry of Health of the Russian Federation

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Mobilan (M-VM3) on both Day 1 and on Day 15

Placebo on Day 1 and Mobilan (M-VM3) on Day 15

Placebo on both Day 1 and Day 15

Arm Description

Patients with histologically verified non-metastatic prostate cancer (stage 1 or 3) treated with Investigational Drug Product (Mobilan (M-VM3)) administered 2 weeks apart. All subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.

Patients with histologically verified non-metastatic prostate cancer (stage 1 or 3) treated with Placebo (Glucose 5%) first on Day 1 and Investigational Drug Product (Mobilan (M-VM3)) in two weeks on Day 15. All subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.

Patients with histologically verified non-metastatic prostate cancer (stage 1 or 3) treated with Placebo (Glucose 5%) administered 2 weeks apart. All subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.

Outcomes

Primary Outcome Measures

Frequency and intensity of adverse events (according to CTCAE v 4.03 classification)
Counting of CD4+ and CD8+ cells in prostate biopsy and surgery samples
Using immunological assays

Secondary Outcome Measures

Change in total Prostate-specific antigen (PSA) level
Value of the Irani score of post-operative prostate tissue (if material is available for analysis)
Irani J (1997) scale include histological assessment of slide mounts obtained after operation as follow: Degree of immune cell infiltration: 0 - No inflammatory cells, 1 - Scattered inflammatory cell infiltrate within the stroma without lymphoid nodules, 2 - Nonconfluent lymphoid nodules, 3 - Large inflammatory areas with confluence of infiltrate
Value of the Gleason score of post-operative prostate tissue (if material is available for analysis)
The Gleason grading system is used to evaluate the stage of prostate cancer using samples from biopsy or post- surgical samples as follow: 1 - The cancerous prostate closely resembles normal prostate tissue. 2 - The tissue still has well-formed glands, but they are larger and have more tissue between them. 3 - The tissue still has recognizable glands, but the cells are darker. 4 - The tissue has few recognizable glands. 5 - The tissue does not have any or only a few recognizable glands.
Plasma concentration of inflammatory cytokines
Presence of protein 502s in blood plasma
Using ELISA assay
Presence of protein 502s in prostate biopsy and surgery samples
Using ELISA assay
Presence of protein TLR5 in prostate biopsy and surgery samples
Using ELISA assay

Full Information

First Posted
July 14, 2016
Last Updated
September 19, 2017
Sponsor
Panacela Labs LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02844699
Brief Title
A Multicenter Randomized Double-blind Placebo-controlled Pilot Study of Safety, Pharmacodynamics and Efficacy of Different Treatments of Immunotherapeutic Drug Mobilan (M-VM3) in Patients With Diagnosed Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Unknown status
Study Start Date
July 2016 (undefined)
Primary Completion Date
January 2018 (Anticipated)
Study Completion Date
January 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Panacela Labs LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A Phase Ib2, multicenter, randomized, double-blind, placebo-controlled safety and efficacy study evaluating different regimens of the immunotherapeutic drug, Mobilan (M-VM3), in patients with prostate cancer.
Detailed Description
Mobilan is a nanoparticle-formulated, recombinant non-replicating adenovirus immunotherapeutic drug that directs expression of both toll-like receptor 5 (TLR5) and a specific agonistic ligand, entolimod (which is a recombinant form of the natural TLR5 ligand, flagellin). The viral construct infects cells expressing the Coxsackie virus and adenovirus receptor (CAR), which has been shown in preclinical studies to be highly expressed in human prostatic tissue, including prostate cancer tissue. Upon infection, co-expression of both receptor and ligand in the same transfected cell triggers persistent autocrine stimulation of the nuclear factor-kappa B (NF-κB) signaling cascade. In a syngeneic mouse prostate cancer model, prostatic injection of Mobilan leads to activation of an innate immune response with infiltration of neutrophils and natural killer cells (NK) cells and induction of an adaptive immune response, comprising cytotoxic (cluster of differentiation [CD]8+) T cells. Necrotic changes in tumor cells were observed in Mobilan-treated animals with concomitant reductions in prostatic volume. Mobilan also show anti-metastatic activity in a surgical adjuvant mouse model of prostate cancer. This clinical trial is a Phase Ib double-blinded, randomized, placebo-controlled trial evaluating the efficacy, safety, and pharmacology of either 1 or 2 injections of Mobilan or placebo when administered as neoadjuvant therapy directly into the prostates of patients with newly diagnosed prostate cancer. All study subjects will receive 2 study drug injections administered 2 weeks apart and will be randomly allocated in a 1:1:1 ratio to 1 of the following 3 drug administration schedules: Arm A: Mobilan on both Day 1 and on Day 15. Arm B: Placebo on Day 1 and Mobilan on Day 15. Arm C: Placebo on both Day 1 and Day 15 Subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
prostate cancer, adenovirus, TLR5, immunotherapy, Ad5

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Mobilan (M-VM3) on both Day 1 and on Day 15
Arm Type
Experimental
Arm Description
Patients with histologically verified non-metastatic prostate cancer (stage 1 or 3) treated with Investigational Drug Product (Mobilan (M-VM3)) administered 2 weeks apart. All subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.
Arm Title
Placebo on Day 1 and Mobilan (M-VM3) on Day 15
Arm Type
Experimental
Arm Description
Patients with histologically verified non-metastatic prostate cancer (stage 1 or 3) treated with Placebo (Glucose 5%) first on Day 1 and Investigational Drug Product (Mobilan (M-VM3)) in two weeks on Day 15. All subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.
Arm Title
Placebo on both Day 1 and Day 15
Arm Type
Placebo Comparator
Arm Description
Patients with histologically verified non-metastatic prostate cancer (stage 1 or 3) treated with Placebo (Glucose 5%) administered 2 weeks apart. All subjects will subsequently undergo planned prostatectomy, ideally within 2 weeks following the final study drug injection and will remain under observation thereafter.
Intervention Type
Drug
Intervention Name(s)
Mobilan (M-VM3)
Intervention Description
Mobilan (M-VM3), innovative experimental drug based on non-replicate adenoviral delivery system consisting genomic vector coding TLR5-receptor and its ligand 502s.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Dextrose 5%, Glucose 5%
Intervention Description
5% infusion solution of dextrose (glucose)
Primary Outcome Measure Information:
Title
Frequency and intensity of adverse events (according to CTCAE v 4.03 classification)
Time Frame
Baseline to up to 45 days after the first drug administration
Title
Counting of CD4+ and CD8+ cells in prostate biopsy and surgery samples
Description
Using immunological assays
Time Frame
Baseline to up to 45 days after the first drug administration
Secondary Outcome Measure Information:
Title
Change in total Prostate-specific antigen (PSA) level
Time Frame
Baseline to up to 45 days after the first drug administration
Title
Value of the Irani score of post-operative prostate tissue (if material is available for analysis)
Description
Irani J (1997) scale include histological assessment of slide mounts obtained after operation as follow: Degree of immune cell infiltration: 0 - No inflammatory cells, 1 - Scattered inflammatory cell infiltrate within the stroma without lymphoid nodules, 2 - Nonconfluent lymphoid nodules, 3 - Large inflammatory areas with confluence of infiltrate
Time Frame
On Day 30 after the first drug administration
Title
Value of the Gleason score of post-operative prostate tissue (if material is available for analysis)
Description
The Gleason grading system is used to evaluate the stage of prostate cancer using samples from biopsy or post- surgical samples as follow: 1 - The cancerous prostate closely resembles normal prostate tissue. 2 - The tissue still has well-formed glands, but they are larger and have more tissue between them. 3 - The tissue still has recognizable glands, but the cells are darker. 4 - The tissue has few recognizable glands. 5 - The tissue does not have any or only a few recognizable glands.
Time Frame
On Day 30 after the first drug administration
Title
Plasma concentration of inflammatory cytokines
Time Frame
Baseline to up to 45 days after the first drug administration
Title
Presence of protein 502s in blood plasma
Description
Using ELISA assay
Time Frame
Baseline to up to 45 days after the first drug administration
Title
Presence of protein 502s in prostate biopsy and surgery samples
Description
Using ELISA assay
Time Frame
Baseline to up to 45 days after the first drug administration
Title
Presence of protein TLR5 in prostate biopsy and surgery samples
Description
Using ELISA assay
Time Frame
Baseline to up to 45 days after the first drug administration

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subscribed Informed consent for participation in the trial Men aged 45 to 75 years Patients with histologically verified prostate cancer, stage Т1-Т3, N0, M0 Patient's ECOG status 0-2 Negative tests for serologic markers of HIV-infection, viral hepatitis В and С, syphilis Patient and his partner should agree to use barrier contraception throughout the study period Exclusion Criteria: Failure to obtain Informed consent Clinical or radiological signs of metastases Indication to hormone therapy of prostate cancer Clinically significant cardiovascular diseases: Myocardial infarction within 6 months prior the screening Unstable stenocardia within 3 months prior the screening Severe circulation failure (FC III) Clinically significant arrhythmias Hypotension (systolic blood pressure < 86 mm Hg) or bradycardia with HR < 50 beats per min. Uncontrolled arterial hypertension (systolic blood pressure > 170 mm Hg or diastolic blood pressure > 105 mm Hg.) Clinically significant CNS diseases at the screening Current infection or another severe or systemic disease which increases risk of treatment sequel Pituitary gland or adrenal disorders in medical history Other malignant tumors within the last 5 years Other concomitant diseases in medical history which according to Investigator may aggravate during the study, including uncontrolled diabetes mellitus, rectal diseases, rectal fissures, hemorrhoid, rectal polyps, rectostenosis, inflammatory urinary diseases: chronic prostatitis, cystitis, urethral catheter, chronic urine retention. Complicated allergic history, systemic allergic reaction, any dietary allergy, intolerability, limitations or specific diets which according to the Investigator may be a contraindication for subject participation in the present study. Administration of drug products which have a marked effect on immune system within 3 previous months prior the screening, long-term intake of disaggregants (warfarin, low molecular heparin except for ThromboASS). Participation in other clinical studies or administration of investigational drug products within 30 days prior the screening, or persisting adverse reactions of any investigational drug product. Any clinically significant patient's health disorders and/or laboratory abnormalities not enlisted in the Protocol which are identified at the screening, and/or any reason which according to the Investigator may prevent the patient's participation in the study. Drug or alcohol abuse at the screening or in the past which according to the Investigator makes the patient ineligible for participation in the study. Vaccination made 14 days prior the study Unability to understand or follow study instructions Lack of availability during 6 months after administration of the investigational drug product, fails to follow visit schedule 19. Individual intolerability of the investigational drug product components Study withdrawal criteria: Any patient may refuse from the study participation on his own wish in any moment on any study stage. Principal Investigator may withdraw any patient from the study in the following cases: Investigator makes the decision that a patient should be withdrawn in his own best interests Patient develops any serious adverse reactions/events in the screening period Patient has been enrolled to the study with violations, or does not follow the protocol requirements Patient needs additional treatment in the screening period Sponsor has right to terminate the study in any moment. Regulatory authorities have right to terminate the study in any moment.
Facility Information:
Facility Name
Moscow State Budgetary Healthcare Institution "City Clinical Hospital № 57" of Moscow Healthcare Department
City
Moscow
Country
Russian Federation
Facility Name
Moscow State University of Medicine and Dentistry
City
Moscow
Country
Russian Federation
Facility Name
Federal State Budgetary Institution "Saint Petersburg Clinical Scientific and Practical Center for Special types of medical care (Oncological)"
City
Saint Petersburg
Country
Russian Federation
Facility Name
Federal State Budgetary Institution "Scientific Research Oncology Institute named after N.N. Petrov" of the Ministry of Health of the Russian Federation
City
Saint Petersburg
Country
Russian Federation

12. IPD Sharing Statement

Learn more about this trial

A Multicenter Randomized Double-blind Placebo-controlled Pilot Study of Safety, Pharmacodynamics and Efficacy of Different Treatments of Immunotherapeutic Drug Mobilan (M-VM3) in Patients With Diagnosed Prostate Cancer

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